To analyze prevailing oral hygiene practices and oral health awareness among urban Saudi Arabians in relation to age, gender and educational level. Structured interviews with 1155 regular patients at two centers providing dental care for university and military staff and their families, respectively, in the city of Makkah. Consecutive patients were stratified by gender and age, into 6 categories from 10 to 60 years, with 50 male or female subjects in each group at each center. Oral hygiene habits and attitudes to oral health were correlated with age, gender and educational levels, using ANOVA. For the majority (> 88%) oral hygiene routines were introduced very late, after the age of 7 yr. Habits were strongly correlated to the level of education (p 0.001); subjects with less education favored the miswak. Among the better educated, toothbrushing started earlier (p 0.001). Regular miswak use was more frequent in older age groups (p 0.001). Females used a toothbrush more often than males (p 0.001), and miswak use by women was less frequent than by men (p 0.001). Despite the availability of free dental care at the public health centers, 89% of the participants at the military center sought only emergency care, in contrast to 54% at the university center. Among urban Saudi Arabians, oral hygiene routines are introduced relatively late in life and knowledge and awareness of oral health is very low. There are pronounced variations in oral hygiene habits, related mainly to age and educational levels. Such factors should be taken into account when planning oral health strategies. Schlagwörter: chewing stick, dental, education, oral hygiene, practice